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Biomedical subjects

R Ewert

Publications and source records attributed to R Ewert.

At least 73 records · Page 4Linked to original sources
PubMed1996

Behet's syndrome with pulmonary involvement-combined therapy for endobronchial stenosis using neodym-YAG laser, balloon dilation and immunosuppression.

We present a case report of a patient suffering from Behet's syndrome with pulmonary involvement. The development of endobronchial granulomatosis in the bronchus intermedius and right upper lobe bronchus led to severe bronchial stenosis and dyspnoea. Also aphthous ulcerations in the bronchial mucosa occurred. Treatment of the granulomatous stenosis consisted of Neodym-YAG laser resection and immunosuppression. On follow-up there was a recurrence of the stenosis, characterised by fibrotic strictures. Therefore a balloon dilation was performed and immunosuppression instituted, which led to an increase in airway diameter and a reduction in dyspnoea. These clinical results suggest that recanalisation therapy with Neodym-YAG laser and/or balloon dilation with additional immunosuppression is suitable in benign stenosis (granulomatous or fibrotic), caused by Behet's disease.

Adult↗
PubMed1996

[Interventional pneumology: procedures for pulmonary hemorrhage and tumor-induced superior vena cava syndrome].

Interventional pneumology includes both bronchological and vascular methods of diagnostic and therapy, especially in case of pneumological emergency, such as pulmonary hemorrhage and superior vena cava syndrome. In massive pulmonary hemorrhage bronchological diagnosis is needed to determine the location and activity of the bleeding, as well as angiography of bronchial arteries, and of pulmonary arteries, respectively. Bronchus occlusion by aid of balloon catheter or double lumen tube are intermediate methods to bridge over till defenitive surgery or embolisation of bronchial or pulmonal arteries as complementary methods in patients with pulmonary hemorrhage. In patients suffering from superior vena cava syndrome caused by neoplasms venous angioplasty and Wallstent implantation provide immediate clinical improvement.

Angioplasty, Balloon↗
PubMed1995

[Aspiration of petroleum by a "fire-eater"].

A 21-year-old man suffered from cough, dyspnoea and hemoptysis following accidental aspiration of petroleum. Chest x-ray and computerized tomography one day after the aspiration showed infiltrates in the lower fields. Fiberbronchoscopy revealed severe bronchitis without any signs of necrosis. Flunisolide inhalation (200 micrograms/d) and intravenous application of prednisolone (50 mg/d) and clindamycine (600 mg/d) improved pulmonary function within a few days. The infiltrates resolved over the following two weeks. This favourable result clearly shows that conservative treatment has a role in petroleum aspiration.

Administration, Topical↗
PubMed1994

Late acute rejection in long-term renal allograft recipients. Diagnostic and predictive value of circulating activated T cells.

Episodes of acute rejection can occur in functional renal grafts even at a very late stage after transplantation. They are not necessarily due to patient noncompliance. The incidence of late acute rejection is commonly underestimated because the diagnosis generally requires histopathology in order to rule out other origins of declining graft function, even more so, as the typical signs of acute rejection as seen in the early posttransplantation period (sudden and rapid increase of creatinine serum level, inflammatory signs) are missing. Histology revealed acute rejection in 157 of 412 renal allograft recipients suffering from progressive graft deterioration between the 2nd and 18th year after Tx. Late acute rejection was clearly associated with elevated levels of activated HLA-DR+ T cells in the peripheral blood. These cells were characterized by flow cytometry to be postmitotic activated effector-T cells belonging to the CD4+ and CD8+ "memory" T cell pool. The high sensitivity (97%) and specificity (88%) of flow cytometric analysis allows for the discrimination between late acute rejection and other causes of deteriorating graft function (infection, toxicity, arteriopathy, chronic rejection). Additionally, this immune monitoring can predict the success of antirejection therapy as early as a few days after initiation of treatment while conventional parameters do not reflect the therapeutic result until 1-3 weeks later. In addition to this, peripheral T cell activation also seems to identify a subgroup of patients with chronic rejection who would respond, at least partially, to steroid bolus therapy. As a result, this parameter is very useful for the clinical management of patients suffering from late deterioration of renal graft function.

Acute Disease↗
PubMed1994

[Xenon computerized tomography of kidney transplants].

Xenon-CT is an established method for determining cerebral perfusion, while applications in other organs are rare. We evaluated the diagnostic potential of measuring the regional Renal Blood Flow (rRBF) in 10 patients with transplanted kidneys by xenon-CT. We found significant differences in the rRBF between the renal medulla and the cortex. There were no differences between normal renal transplants and transplants with chronic rejection.

Adult↗
PubMed1992

[The accidental aspiration and ingestion of petroleum in a "fire eater"].

A 26-year-old man, practicing for a variety performance as "fire-eater", accidentally inhaled and ingested about 10 ml petroleum. Soon afterwards he developed dyspnoea, an urge to cough, fever up to 39 degrees C and loss of retentiveness. He was treated as an out-patient with doxycycline, 100 mg daily, and aspirin, 500 mg three times daily. While this reduced the dyspnoea, the elevated temperature persisted and he had haemoptysis. Chest x-ray and computed tomography 12 days after the aspiration revealed areas of atelectasis and of liquefaction necroses. Bronchoscopic and cytological examinations showed eosinophilic alveolitis and mucosal necrosis in both main bronchi. The symptoms were improved by two inhalations of beclomethasone four times daily, and systemic treatment with prednisolone, 50 mg daily, together with parenteral antibiotic administration (cefotaxime, 1.0 g twice daily). The focal lung lesions regressed completely within a few weeks. Five months after the aspiration computed tomography merely demonstrated discrete scarring of the previously necrotic lesions. This case illustrates that, even with extensive necrotic lung changes after petroleum aspiration, conservative treatment is justified and likely to be effective.

Adult↗